Latest / Becker’s Healthcare - Clinical Leadership Podcast / Dr. Nadim Ilbawi, Physician Director of Innovation and Care Models at NorthShore Edward-Elmhurst Hospital

Transcript

Dr. Nadim Ilbawi, Physician Director of Innovation and Care Models at NorthShore Edward-Elmhurst Hospital · Becker’s Healthcare - Clinical Leadership Podcast

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  Would you like to exchange best practices and ideas to improve care,
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  enhance operational efficiency,
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  and address financial challenges with your peers?
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  Becker's Healthcare is facilitating these conversations at their eighth annual
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  health, it digital health and R C M meeting.
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  You can check your eligibility for complimentary attendance at the link in the
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  description. We are excited to welcome you in October.
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  This is Laura Deda with the Becker's Healthcare Podcast.
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  I'm thrilled today to be joined by Dr. Nadine Ibai,
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  physician director of innovation and care models at North Shore Edward Elmhurst
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  Health Hospital. Nadine, it's a pleasure to have you on the podcast today.
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  Thank you, Laura. Thanks for having me.
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  Now, I know we've got a lot to talk about.
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  There's so much happening in healthcare right now,
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  and especially it is such a fascinating time with how technology is really, uh,
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  driving forward some really big trends and exciting things in the healthcare
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  space. But before we dive into my questions,
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  can you tell us a little bit more about yourself and your background?
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  Yeah, absolutely. I have,
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  I think both a traditional and somewhat non-traditional entry into,
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  into medicine. I went through,
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  through med school residency without taking any time off. And then prior to, um,
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  starting my work here 12 years ago, I, I,
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  I knew that I'd wanna start with my pa uh, my patient panel and,
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  and stay with them for the entirety of my career. So I decided to do,
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  do a year of travel, kind of took a,
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  took a break between residency and starting this job, uh,
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  and volunteered and traveled around the world, uh, 19 different countries.
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  I went with my wife and actually had my first job as a physician in New Zealand
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  as a locums doctor for, for three months on the south island of New Zealand,
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  which was really, uh, a transformational experience for me. Um, in addition to,
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  to some work I did in other countries as well. Sore really, um,
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  neat opportunity and, and gave me some perspective going into my career. Um,
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  and, and really have been grateful and thankful to be with the,
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  the same patients, uh, since I started here at North Shore, Edward Elmer Health,
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  uh, 12 years ago. Um, and since that time I've had really, again,
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  grateful to have lots of different roles. Um, I, I've been a physician advisor,
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  um, working on complexity capture, HCCs, um, in the primary care space,
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  uh, also as have helped stand up our personalized medicine, um, program,
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  which is, is really something we're very proud of, uh, in, in, you know,
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  incorporating genetics and genomics into, into primary care. Um, and,
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  and also had, uh, opportunities to work, uh, with our University of Chicago, uh,
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  medical students and, uh, the medical student rotation here for family medicine.
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  So, um, that's all to say, yeah, I'm a family doctor and that's,
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  that's something I'm very passionate about and have maintained that practice.
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  Um, my current roles, you mentioned the innovation and care model redesign. Uh,
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  I also chair our medical groups Physician Engagement and Wellbeing committee,
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  uh, which has been really an honor for me as well for the last, uh, four years.
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  That's amazing to hear.
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  What's great experiences and background you have both in practicing medicine as
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  well as connecting with patients and then now working with, um,
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  up and coming physicians and clinicians and care teams as well.
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  That's amazing to hear.
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  And I was particularly interested when you were talking about standing up the
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  personalized medicine program and incorporating that into primary care. Um,
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  could you touch a little bit more on that in, you know,
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  how you built the program, what you were able to do, um, at,
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  with the technology at the time, and how it's progressed since then? Yeah.
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  No, great question. And honestly, a lot, lot of credit to the, to the,
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  the geneticists and, and,
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  and many members of our administrative and operational team, they,
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  they brought me on after they had really stood up the concept of personalized
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  medicine. Uh, and something this organization's been really, uh, keen on for,
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  for many years. And,
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  and really what's different and unique about it is that it's incorporated or
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  questions that are along the lines of family history questionnaires are
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  administered to our patients ahead of time, of their physical. And we've, um,
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  got an incredible team that's put together workflows in the technology within
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  our EMR to allow the physician at the point of care to not only have information
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  available for them for counseling,
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  cuz every physician has a different level of understanding and, um,
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  comfort with genomics, uh, especially in the primary care space.
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  And so this really was a way for us to be able to give our physicians the
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  opportunity to, uh, guide their patients on evidence-based, uh,
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  genetic testing and provide that, um, uh, really at a,
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  at a pretty low cost and then have the, uh,
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  backend work and workflows to, to result those, um,
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  and that information to our patients and get them to the right care team members
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  for, for their care. So, you know, we have had, um, really, uh, a ton,
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  uh, uh, of, um, our numbers have been very,
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  very high in terms of the number of patients that have completed the testing.
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  I think over 31,000 have done the testing. Um, these questionnaires,
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  I think around 250,000, uh, and over 3000 patients.
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  This is the most relevant of course, cuz it's clinically relevant,
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  which is that over 3000 patients have been found to have, uh, a variant, uh,
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  a a genetic variant. And that does not include pharmacogenomics, which is, uh,
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  some of the testing we were doing as well.
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  Got it. That's fascinating.
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  Thank you so much for sharing a little bit about the program with us. Now,
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  I'm wondering from your vantage point,
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  especially looking at the innovation in in care models,
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  where are some of the big opportunities that you are seeing ahead of,
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  as well as the headwinds that you've got your eye on?
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  Yeah, listen, I think the headwinds, uh, are, are the,
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  are similar to what every, um,
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  healthcare organization's experiencing in terms of,
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  of cost and decreased reimbursement and, and staffing. Um,
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  I'm particularly focused on joy in practice and top of license
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  work. You know,
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  obviously pre pandemic burnout rates for physicians and clinicians in general
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  was, was already pretty high, uh, relative to other professions. Uh, and,
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  and part of that was the moral injury of feeling like there was so much you
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  wanted to do for your patient, um,
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  but having so many of the clerical and administrative tasks that were really
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  preventing you from doing that the way you wanted to and maintaining a good
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  work-life balance. And so that,
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  that is the one I'm focused on the most and have been really focused on the most
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  too. Uh, and, and really the wellbeing of our team members, I think is,
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  is paramount to, um, translating to a good, uh,
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  patient experience as well and good clinical care. So, so with the headwinds,
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  uh, that have accelerated over the, the last three years and with the pandemic,
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  I would say there's obviously, um,
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  a lot of opportunity that has come around with that. Uh,
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  and part of that is leveraging technology to really offload some of that
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  clerical work that we were talking about,
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  some of the things that don't really bring, um, joy or purpose to our every day.
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  So, you know, I, I think trying to find those points, uh,
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  for all of our team members is really gonna translate into just better wellbeing
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  and, and, and joy and work. We spend tons of our life in work lots,
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  a huge percent of our, our life is in our jobs.
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  And so you want everyone you're working with to enjoy it and feel like there's
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  purpose in that work. Um, our, our Edward, I'm sorry, Elmhurst Hospital,
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  for example, um, brought in a robot called Moxie. Um,
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  this is an example of, you know, uh, a robot that's able to take, uh,
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  medications and, and, and other, uh, instruments, uh, across the hospital and,
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  and a very simple and straightforward example of how, um, you know,
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  we can leverage technology to take work off the plate of our,
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  of our team members that isn't really purposeful or meaningful. Um,
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  and another part of the opportunity I see here is obviously we've been able to
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  engage our patients in different ways and at times and places that is more
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  convenient to them.
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  So there's huge opportunity there because traditionally I think medicine within
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  the four walls of our healthcare system, you know,
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  felt more transactional and we're really having an opportunity here to,
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  to impact health. And health is so much more than just when the patient is in,
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  whether it's for prevention for a six visit, you know,
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  health is is really what we do in the community,
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  what we do when we're not seeing the patient. Uh, and recently we had a,
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  a really nice partnership, uh, and opportunity to develop, uh,
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  cardiac rehab. It's the first in-home virtual cardiac, um,
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  recovery program with a company called Motive. Um,
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  and it's really an example of, uh, I think, uh, innovative and, um,
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  opportunistic,
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  meaning the opportunity based on the virtual care offerings that we have to,
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  to help patients in a place that's convenient for them, uh, and,
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  and really very holistic as well.
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  I love that. I, I think there's just so much there in terms of, um,
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  troubleshooting some of the big challenges in leveraging technology in order to
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  fill some of the gaps that, you know, we're seeing in healthcare,
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  whether it's the staffing shortages and, and the challenges on that front,
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  or really being able to optimize the outcomes, um,
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  in care delivery in the best way possible. And so I really appreciate, um,
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  everything that you're talking about here. And I, I know too, um,
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  in terms of connecting with patients and engaging them in different ways,
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  it seems like there's certainly a push in healthcare right now, um, to,
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  to really focus on the patient and their family and the expectations of the care
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  experience and, um, you know,
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  having them become more of part of their care journey as well. Uh,
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  how do you see that playing out in really, you know,
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  what from your perspective is essential for hospitals and health systems to be
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  thinking about, you know, when they,
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  they have an eye on that patient experience in,
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  in that journey and engagement within their own care?
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  Yeah, I, I love that question because I, I think some may see it as,
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  um, potentially threatening, right? When you think about consumerization of,
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  of medicine and the patient experience, um, that that's, uh,
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  that's a big deal because, you know,
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  what we're ultimately trying to do is provide the best health to our patients,
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  but sometimes they perceive that in different ways, right?
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  Or how they want to get their healthcare, um,
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  when and what health means to them. So,
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  so I actually really like this concept because,
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  and I actually think this is gonna be one of the keys to success,
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  is that we really start to, to hone in on patients, um,
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  with that very personalized touch in mind. And so, so for me,
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  that means both precision medicine in regards to genomics, uh,
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  polygenic risk scores, things like that. Uh, but also very personalized that,
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  you know, familiar touch points with the healthcare system that does not feel
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  transactional at all.
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  And that's exactly where I think team-based care comes into play here,
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  is that if we have a group of individuals that are really the,
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  the, the same people that, that are,
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  are hearing or that the patient is hearing from in the health system,
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  or that at most points in the patient's interaction with the healthcare system,
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  they feel like they're known to the system.
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  That I think has tremendous implications and potential for better health
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  because, you know, we, we know that we can give our patient guidance and, and,
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  and recommendations in the office,
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  but how hard is it to really implement those changes in one's behavior or health
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  once they leave the office? Uh,
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  and I think this is a chance for us to really ask patients how we can do that
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  best for them, uh, and it's a win-win for everybody.
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  That's amazing to hear and definitely such a helpful perspective.
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  Now from your vantage point,
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  how do you think about growth and adding value to the health system overall?
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  What does that look like for you and the teams that you work with?
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  Yeah, I think it, you know,
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  it goes back a little bit and I wanna be too repetitive, Laura, about this,
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  but I, I think, um, for me, you can look at value. If you look at it as,
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  you know, quality over cost. There,
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  there are definitely efficiencies that can be gained by the team-based care
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  model. Um, so I think, again,
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  everyone working at the top of their license and doing it in a collaborative way
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  and doing it a way, uh,
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  that's reproducible so that way the patient has the same experience every time,
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  regardless of who the patient is. Uh,
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  it is really something that I think team-based care can, can work towards. Um,
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  and along that same vein, if you look at, um, again, value considering quality,
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  uh, and cost, you know, the approach reduces, uh, reduces burnout.
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  It reduces turnover. Um, it really does improve the patient experience.
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  And I think by providing that value, value, um, we will, we will have growth.
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  Fantastic. I, I,
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  I really think that that value equation is a great way to look at it and making
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  sure that you have your eye on the prize and focus on the right things.
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  And you know, too, when, um, we're, we're talking about healthcare today,
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  there's a lot of anxiety around some of the financial challenges that, you know,
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  mm-hmm.
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  economic situation is tough for many organizations across the
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  country and, and resources are slim.
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  So where do you see as being important areas to continue to invest? Um,
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  even if budgets are a little bit tighter than they have been in the past, I.
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  Think it's gonna be in those,
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  those tools that help us automate and do the redundant work, um,
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  the, the same and with technology every time because we, you know,
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  this is an example of where technology can supplement but not replace the
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  people.
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  And so when our organization is able to focus on the patient right in front of
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  the clinician or in front of the medical assistant, um,
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  or in front of anybody for that matter, i, I, I think that's,
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  that's exactly what we need to put our bets on.
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  And so any technology that allows for that to happen, um,
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  I think is worth looking into and investing. And, and so for example,
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  ambient listening, that that might be, you know, a good, um,
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  I wouldn't say necessarily risk,
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  but that could be a very good investment when you think about what it does, um,
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  for both the, the clinician and the patient and,
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  and the value of the care that they are provided. Um,
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  that I think will pay dividends, uh, over time for sure,
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  and is a worthwhile investment. Um, you know, in terms of risk, I,
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  I, I'm probably, I'm obviously not the first person that's on your podcast,
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  I'm sure to talk about a ai,
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  but I really do think this is an area where when we know how fast
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  this has accelerated over the last year or two, um, you know,
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  faster than anything,
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  most of us did anticipate we should start thinking about how the next few years
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  we can just almost consider it a given that it is going to be a part,
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  maybe at first, uh, of how we do some of the other clerical work,
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  but then ultimately get, helps us, uh,
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  our patients get to the right point of care at the right time, uh,
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  and really again, supplements the work that we're doing. So it's, it's a,
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  it's a risk, uh, for many reasons,
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  but I think it's a risk definitely worth investing in.
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  Absolutely. And I, I think too, looking at ai,
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  there's a lot of different opportunities with the technology, but certainly, um,
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  being able to use it to your advantage and not, um, get to a point where it,
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  it's not beneficial for healthcare, I think is important, as you mentioned.
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  Exactly. Um, well before we wrap up our conversation, I just wanted to ask,
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  where do you see some of the best opportunities for growth and development for
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  you as well as the teams that you work with?
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  Um, so you, you know, we're, we're now a nine, uh, an eight, uh,
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  or nine hospital, uh, system, right nine because we have a, a mental health, uh,
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  inpatient, uh, hospital. Um, and,
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  and we're still focused and we'll continue to focus on being community
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  connected. And I really feel, going back to what I was mentioning earlier about,
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  uh, transactional care versus, you know, continuous care. Our, our mission is,
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  is to help everyone in their communities be their best.
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  And that means we have to be involved in our communities in as many ways as
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  possible. And by investing in our communities, which we've been doing, um,
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  I really think that gives us opportunities for growth. And so that means, um,
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  that the people that work with and for us are coming from the communities we
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  serve, um,
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  making sure that we are investing in the things that matter to the communities
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  and really finding ways, and this is where we should and can be creative, uh,
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  about, um, the care that patients receive, being much more about prevention,
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  uh, and, and, and, and, and helping them be as healthy as they can be. Uh, so,
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  so that they live really their best lives.
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  I love it. Nadia, thank you so much for joining us on the podcast today.
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  This has been such a fun conversation and I'm excited to see you in person at
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  our event this October. Um, the Health IT,
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  digital Health and Revenue Cycle event, it's gonna be such a fun, um,
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  space to be in. And a lot of these themes,
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  I know we're talking about very closely with the mix of clinical and technology
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  in where really healthcare is headed. So I'm looking forward to that very much.
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  Me too, Laura. Thank you. I really appreciate that.